JP2004202230A - Equipment for bio-mechanical template treatment capable of controlling and for resection, and related method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a stated tool (100) for supporting to select a stated implant (400) whose size is suitably adjusted for using in case of arthroplasty. <P>SOLUTION: The tool (100) works together with a stated anatomical joint (101) or a stated image (102) of the anatomical joint (101). The tool (100) is equipped with a stated main part (110) and a stated segment part (114) for conforming to the first part (112) of the anatomical joint (101). This segment part (114) can move to the main part (110). Furthermore, this segment part (114) conforms to the second part (116) of the anatomical joint (101). The main part (110) and the segment part (114) accommodate for measuring each relative position of the first part (112) and the second part (116) of the anatomical joint (101) for using to select the implant (400) whose size is suitably adjusted. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

Cross-Reference to Related Applications The following patent applications have been cross-referenced. DEP 666, entitled "ALIGNMENT DEVICE FOR MODULAR IMPLANTS AND METHOD," filed concurrently with the present patent application, which is incorporated herein by reference. , DEP725, entitled "INSTRUMENT AND ASSOCIATED METHOD OF TRIALING FOR MODULAR HIP STEMS", and "Modular Hip DEP5004, whose title is "MODULAR HIP STEMS AND ASSOCIATED METHOD OF TRIALING".
The present invention relates generally to the field of orthopedics, and more particularly to an implant for use in arthroplasty.

  Patients with pain and immobility caused by osteoarthritis and rheumatoid arthritis have the option of joint replacement surgery. This joint replacement surgery is fairly common and allows many individuals to function properly that would otherwise be impossible. The various prosthetic joints typically include metal, ceramic and / or plastic parts that are fixed to existing bone.

  The joint replacement surgery described above is also known as joint arthroplasty. Such gross arthroplasty or total joint replacement is a well-known surgical procedure in which a diseased and / or damaged joint is replaced by a prosthetic joint. In a typical total joint replacement, the ends or tips of the various bones adjacent to the joint are removed or a portion of the tip of the bone is removed, leaving an artificial joint in the joint. Fixed.

  It is known that there are many designs and methods for manufacturing implantable articles, such as various bone prostheses and the like. These bone prostheses include components in various artificial joints such as elbows, hips, knees and shoulders, and the like.

  At present, one of the key issues is joint instability in total hip arthroplasty. This instability is associated with dislocation of the joint. This dislocation is particularly problematic in total hip arthroplasty.

  Factors related to the transposition include surgical techniques, implant design, implant positioning, and patient-related factors. In total hip arthroplasty, this problem is addressed by providing a range of products with a range of lateral misalignments, neck length, head length and foot length. . The combination of these four factors has an effect on soft tissue loosening. By optimizing the various biomechanical factors, surgeons can provide certain patients with a stable hip joint that is much more resistant to dislocation.

  To accommodate certain patient and anthropometric ranges, the assignee of the present patent application, DePuy Orthopaedics, Inc. and other companies, now offer a wide range of hip implant shapes. Being manufactured. In particular, the S-ROM (S-ROM) total hip replacement system provided by DePuy Orthopedics, Inc. has three types of offset portions, three types of neck lengths, and four types of head portions. And adjusting the length of one foot. However, the combination of all these biomechanical options is rather complex.

  At present, surgeons require a radio to aid in selecting a prosthesis for a given patient with proper lateral offset, neck length, head length, and foot length. A graph (X-ray photograph) is used. Surgeons have utilized the above radiography technique by overlaying an acetate overlay on a radiograph of the patient's femur and acetabulum. Each prosthesis implant corresponds to a particular acetate overlay. In this way, the surgeon selects the acetate overlay that most closely corresponds to the patient's natural femur. In addition, the surgeon can utilize a single non-adjustable instrument (eg, DePuy instrument number 53-1420) during surgery to determine the center of the exposed bone head. Such a single instrument or femoral resection template shows only one example of a biomechanical combination and is incompatible with the patient-templated structure in its X-ray.

  Therefore, a need exists for certain prosthetic implants with additional functionality.

  The invention includes certain devices and certain related methods. The device is an adjustable device that allows the user to slide the neck in a lateral direction from a center to template the lateral offset. The instrument is also slidable in a constant proximal to distal direction up to the length of the template foot. Optionally, the instrument can slide in an oblique direction to template either the length of its neck or the length of the head or a combination thereof. Additionally, certain portions of the device can be etched to further assist in implant selection to indicate the actual lateral offset, foot length and neck length respectively. .

  The present invention provides an instrument and a method for templating multiple biomechanical combinations with an instrument or tool. This template processing can be accomplished via a number of sliding mechanisms, which allow the device to provide the desired lateral offset, neck length, head length, and / or foot It allows expansion or contraction to length. The instrument also makes it possible to template during and before surgery by using various radiographs.

  According to an example embodiment of the present invention, a tool is provided to assist in selecting an appropriately sized implant for use in performing arthroplasty. The tool cooperates with an anatomical joint or an image of an anatomical joint. The tool has a body portion and a segment portion for alignment with a first portion of an anatomical joint. The segment portion is movable with respect to the body portion. Further, the segment portion is aligned with a second portion in the anatomical joint. The body and segment portions are each adapted to measure the relative position of the first and second portions in the anatomical joint for use in selecting an appropriately sized implant. I have.

  In accordance with another embodiment of the present invention, a particular size of a particular hip joint implant for use in performing a hip arthroplasty to assist in selecting an appropriate one of the plurality of femoral components. A tool is provided for use in measuring at least one of the following. The tool cooperates with an anatomical joint or a radiographic image of the anatomical joint. The tool also has a body portion and a segment portion for engaging a first portion of an anatomical joint. The segment portion is movable with respect to the body portion. The segment portion also engages a second portion of the anatomical joint. The tool is used to measure one of the specified dimensions when the body portion is aligned with the first portion and the segment portion is aligned with the second portion.

  In accordance with yet another embodiment of the present invention, a method is provided for selecting one of a plurality of prosthetic components for use in an arthroplasty. The method includes obtaining a radiographic image. The method further includes a first portion for aligning to a first portion in the radiographic image and a second portion for aligning to a second portion in the radiographic image. And supplying a tool. A first portion of the tool is movable with respect to a second portion of the tool, and the tool is used to measure at least one dimension in the radiographic image. The method also includes aligning a first portion of the tool with a first portion of the radiographic image and aligning a second portion of the tool with a second portion of the radiographic image. . Further, the method includes measuring at least one dimension in the radiographic image and utilizing the tool to select one of a plurality of prosthetic components based on the measured dimension. .

  Technical advantages of the present invention include the ability of the above-described devices and methods to represent a complete range of biomechanical options for use in total hip arthroplasty. For example, in accordance with one aspect of the present invention, telescopic operation can be performed in three directions to repeat lateral displacement, foot length, and neck length. It is. Thus, the present invention provides a variety of biomechanical options, including the choice of lateral offset, foot length, and neck length.

  Another technical advantage of the present invention is that the ability of the present invention allows the surgeon to visually determine the center of the head and the amount of resection before performing a bone cut. is there. For example, according to one aspect of the invention, the template can be placed on a radiograph, the template being adjustable to a position corresponding to the natural femur and acetabulum. is there. Thus, the present invention provides the ability to visualize the center of the head and the amount of resection before making any cuts to the bone. Such pre-cutting visualization is made possible by the use of the instrument in various radiographs or corresponds to the instrument used visually during surgery after exposing the bone prior to the resection procedure. Can be.

  Other technical advantages of the present invention will be readily apparent to one skilled in the art from the following figures, descriptions, and claims.

  Therefore, according to the present invention, a prosthetic implant with additional functionality can be provided.

  According to the present invention, in FIG. 1 a tool 100 is shown. The tool 100 is used to assist in selecting an appropriately sized implant for use in performing arthroplasty. The tool 100 cooperates with at least one of an anatomical joint and an image thereof.

  As shown in FIG. 1, the tool 100 can be used in connection with an acetate plate or a radiographic plate 102. A radiographic image 104 is formed on the acetate plate 102. The x-ray image 104 has a boundary portion 106 that, for example, shows the contour shown in FIG. 1, such as the contour of a long bone, such as a femur. I have.

  The tool 100 has a body portion 110 for engaging a first portion 112 of an anatomical joint 101. The tool 100 further has a constant segment portion 114. The segment portion 114 is movable with respect to the main body portion 110. Also, this segment portion 114 is used for alignment with the second portion 116 in the anatomical joint 101. In addition, the body portion 110 and the segment portion 114 can be positioned relative to the first and second portions 112 and 116 of the anatomical joint 101 for use in selecting a suitably sized implant. Used to measure position.

  As shown in FIG. 1, the tool 100 can also have a second segment portion 120. The second segment 120 may be movable relative to one of the body 110 and the first segment 114. Also, this second segment portion 120 is used to align with the third portion 122 in the anatomical joint 101.

  The tool 100, including the body portion 110, the first segment portion 114, and the second segment portion 120, can be made of any suitable durable material, for example, made of a metal and / or plastic material. it can. Preferably, when utilized to select an implant by visual observation of an exposed femur during an operation, the tool 100 is made of a sterilizable material. Is preferred.

  The tool 100, including the body portion 110, the first segment portion 114, and the second segment portion 120 described above, is any suitable tool that replicates the function of the tool 100 and can be used to select a suitable prosthesis. It can have any suitable size and shape. Preferably, as shown in FIG. 1, when the tool 100 is used with a radiograph 102, if the radiograph is a full-scale radiograph, the tool 100 Can have a profile of the same dimensions as the profile of its corresponding implant. If the X-ray photograph has a reduced or enlarged dimension, the tool 100 needs to be reduced or enlarged to follow the scale and correspond to the scale of the X-ray image. It is considered that this is naturally recognized. Further, when the tool 100 is utilized intra-operatively with certain visual observations of the actual femur and implant, the tool 100 has the same dimensions and shape as the corresponding implant. Must have a shape.

  2 and 3, the body portion 110 of the tool 100 is shown in greater detail. The body portion 110 has a stem portion 124, which has a rectangular cross section, for example, as shown in the figure. This stem portion 124 corresponds to the first portion 112 of the joint 101 (see FIG. 1). The first portion 112 of the joint is the distal stem portion of the femur. An enlarged portion 126 of the main body 110 extends from one end of the stem portion 124. This enlarged portion 126 corresponds to the proximal femur. Further, a slot 130 is disposed longitudinally within the enlarged portion 126 of the body portion 110.

  Referring now to FIG. 4, the first segment portion 114 is shown in greater detail. The first segment portion 114 has a first segment base 132.

  A calcar slide 134 extends in a first direction from the first segment base 132 along a first centerline 136. In addition, rails 140 extend along the kalkar slides 134 at locations opposite the first centerline 136, respectively. These rails 140 cooperate with the slots 130 of the body part 110 (see FIG. 2).

  Referring again to FIG. 4, an offset slide 142 extends outwardly from the first segment base 132. The offset slide 142 extends along the second centerline 144 at a constant angle α of, for example, about 90 degrees with respect to the first centerline 136. In addition, a rail 146 similar to the rail 140 extends from the offset slide 142 in a direction perpendicular to the second centerline 144. These rails 146 cooperate with the slots 150 in the second segment portion 120 (see FIG. 5).

  Referring now to FIG. 5, the second segment portion 120 is shown in greater detail. The second segment 120 includes a sliding portion 152 and a neck portion 154 extending from the sliding portion 152. In addition, the sliding portion 152 includes a slot 150 located along a sliding centerline 156. The slot 150 can have any shape that can guide and restrain the second segment portion 120 within the first segment portion 114, but the slot 150 has It will be appreciated that it is possible to include a proximal lip 160 and a distal lip 162 forming a groove 164. Further, these grooves 164 are dimensioned to engage and engage with each rail 146 of the first segment portion 114.

  The neck 154 extends along the neck centerline 166 in a certain direction defined by the angle β with respect to the sliding centerline 156. This angle β preferably corresponds to the angle of the neck of the prosthesis.

  Referring now to FIG. 6, the tool 100 is shown positioned above a long bone or femur 101. Thus, as shown in FIG. 6, the tool 100 may be used to remove a particular implant prior to commencement of bone resection, removal of the tool from the sterile package, and use of certain trials and trial reductions. Is available during surgery to determine the appropriateness of the femur and can be positioned above the femur 101. Further, the tool 100 can be positioned above the femur 101, and the guide surface portion 172 for resection can be arranged with respect to the femur 101. By the alignment with the guide surface portion 172 for cutting, a certain appropriate cutting surface 74 can be determined.

  Referring again to FIG. 1, the tool 100 may include indicating means 176 to assist in determining the relative position of the body portion 110 with respect to the first segment portion 114. The indicating means 176 may include a single marker 178 on the body portion 110 and a plurality of first segment markers 180 on the first segment portion 114. As the first segment portion 114 slides along the slot 130 in the body portion 110 in the direction of each arrow 182 and 184, the first segment marker 180 aligns with the body portion marker 178, respectively. For example, as shown in FIG. 1, these first segment indicators 180 can be identified by respective reference numerals 186. Further, these reference numbers 186 can indicate a constant relative or absolute distance height, or the appropriate distance indicated by the alignment of the body portion marker 178 with the respective first segment marker 180. It can accommodate specific prostheses with a partial height.

  The body portion and the first segment portion 114 can be selectively fixedly attached to each other. For example, the first segment portion 114 can have a thread engageable hole or opening 190 through which a screw 192 can be secured. The screw 192 can be selectively tightened and loosened as the first segment portion 114 moves to its proper position relative to the body portion 110.

  To assist in positioning the first segment portion 114 relative to the body portion 110 at a position corresponding to the height of the various limbs of the available prosthesis, the body portion 110 may be There may be a plurality of centrally formed recesses 194 which, when in the proper position along the slot 130 in the direction of each arrow 182 and 184, define the height of various predetermined distances. The first segment marker 180 is operably aligned with the screw 192 to position the first segment marker 180 with the body portion marker 178 to correspond to the available prosthesis. The screw 192 may have a spring-loaded ball end (not shown) to cooperate with the recess 194.

  Further, the first segment portion 114 and the second segment portion 120 may have indicating means 195 for determining the relative position of the first segment portion 114 with respect to the second segment portion 120. The indicating means 195, like the indicating means 176, comprises a first segment marker 196 disposed on the first segment portion 114 and a plurality of second segment markers disposed on the second segment portion 120. 197 can be included. In addition, the indicating means 195 may include a plurality of reference numerals 198 associated with the second segment indicator 197. These reference numbers 198 may indicate the position of each offset in absolute or relative sense, or may indicate a particular available prosthesis.

  The second segment portion 120 can be selectively attached to the first segment portion 114 by, for example, a screw 183 similar to the screw 192, and the screw 183 can be attached to the first segment portion 114. Can be fixed by screw engagement through the through-hole 181 at. In addition, a plurality of recesses 185 can be formed in the second segment portion 120 such that when the recesses 185 align with the screw 183, the first segment marking 196 will become a plurality of second segment markings. Each recess 185 is positioned such that it can be aligned with one of the 197s.

  To assist in aligning the tool 100 with either a radiographic image of the femur or the actual femur, the tool 100 may be a translucent or transparent material such as a plastic material or the like. It can be made of various materials.

  According to the present invention, another embodiment of the present invention is shown in FIG. The tool 200 can be used in conjunction with an image 104 of a joint from an x-ray 102, similar to the tool 100 described above. The tool shown in FIG. 7 is used in arthroplasty for the left hip joint. Similar to tool 100 of FIG. 1, tool 200 can be made of any suitable durable material, for example, a metal or plastic material. Further, similar to the tool 100 described above, the tool 200 is comprised of a plurality of parts including a body portion 210 similar to the body portion 110 of FIG. 1, for example, as shown in FIG. ing. Further, as shown in FIG. 7, body portion 210 has a stem portion 224 as well as an enlarged portion 226. The stem portion 224 aligns with the distal portion of the femur 101 and the enlarged portion 226 aligns with the proximal femur.

  As with the tool 100 of FIG. 1, the tool 200 further has a first segment portion 214 slidably secured to a body portion 210 thereof. This first segment portion 214 is slidably movable within the stem portion 224 in the direction of each arrow 282 and 284. The tool 200 further has a second segment 220 that is slidably movable with respect to the first segment 214. Unlike the tool 100, the tool 200 further has a third segment portion 233 that can be slidably moved with respect to the second segment portion 220. This third segment 233 is aligned with the head 201 of the femur 101.

  8, 9 and 11, the body portion 210 is shown in greater detail. The body portion 210 has a distal stem portion 224 and an enlarged portion 226. As shown in FIG. 8, the body portion 210 has an opening 202 therethrough. This opening 202 allows the first segment portion 214 to be observed as it moves up and down in the directions of arrows 282 and 284, respectively. Similar to the body portion 110 of the tool 100 in FIG. 1, the body portion 210 has indicating means 276 to assist in determining the position of the body portion 210 relative to the first segment portion 214.

  For example, as shown in FIG. 11, the indicating means 276 includes a marker 278 located in the first segment portion 214 as well as a marker 280 in the form of a plurality of lines in the body portion 210. Each of these lines 280 can include a corresponding respective number 286, which allows each number 286 to indicate the relative distance between the respective lines 280, or Can be shown to correspond to certain prostheses that are considered to be suitable.

  Referring again to FIG. 8, the first segment portion 214 is slidably engageable with the body portion 210 in the direction of each arrow 282 and 284 in any suitable manner. For example, the body portion 210 can have a slot 230 and the first segment portion 214 can have a calcar slide portion 234. The slide portion 234 can be slidably fitted into the slot 230.

  The first segment portion 214 can be selectively and selectively attached to the body portion 210 by, for example, a screw 292 that can be threadably engaged with the body portion 210 at a hole 290 formed in the body portion 210. It can be fixed so that it can be removed. The screw 292 can have a spring-loaded ball-shaped contact point (not shown) that can contact each recess 294 formed in the first segment portion 214. The point of contact of this screw 292 contacts each recess 294 as the first segment portion 214 moves in the direction of each arrow 282 and 284, and is positioned, in particular, by a constant exposed femur. In this case, the positions of the respective positions can be designated by the respective numerals 286, and the positions can be relatively easily determined.

  Referring now to FIG. 10, a body portion 211 is shown, which is an enantiomer of the body portion 210 and can be used with a right hip arthroplasty. It should be noted that each of the first segment portion 214, the second segment portion 220, and the third segment portion 233, together with the main body portion 211, form a mirror image for each component of the tool 200. It should be appreciated that is available.

  Referring now to FIG. 12, the first segment portion 214 is shown in greater detail. This first segment portion 214 is similar to the first segment portion 114 in the tool 100 of FIG. The first segment portion 214 has a central base 232. Further, a calcar slide portion 234 extends from the central base 232 along a first center line 236. A constant offset slide portion 242 extends from the base 232 at a fixed angle αα with respect to the first center line 236, and the slide portion 242 extends along the second center line 244. are doing.

  Referring again to FIG. 8, the calker slide portion 234 slides along slot 230 in the directions of arrows 282 and 284, respectively. This calcar slide portion is guided and held by each rail 240 extending from the calker slide 234. A marker 278 is located on the calcar slide portion to assist in determining the relative position of the first segment portion 214 with respect to the body portion 210. Further, the offset slide portion 242 is slidably engaged with the second segment portion 220 and is guided by each rail 246 extending from the offset slide portion 242.

  Referring again to FIG. 8, the second segment portion 220 is slidably movable in the direction of each arrow 204 along the offset slide portion 242.

  13, 14, and 15, the second segment portion 220 is shown in greater detail. This second segment portion 220 has a neck portion 254 and a sliding portion 252. In addition, the sliding portion 252 has a slot 250 that cooperates with the offset sliding portion 242 in the first segment portion 214. This slot 250 is defined by lips 260 and 262 forming a groove 264 which engages with each rail 246 of the offset slide portion 242 (see FIG. 8). .

  Preferably, as shown in FIGS. 12 and 14, the tool 200 includes indicating means 195 for determining the relative position of the second segment portion 220 with respect to the first segment portion 214. . The indicating means 195 may be, for example, in the form of a plurality of reference markers 197 on one of the first segment portion 214 and the second segment portion 220 and a certain single marker on the other of the segment portions 214 and 220. it can. For example, second segment portion 220 can have a plurality of fiducial markers 197 and first segment portion 214 can have a single fiducial marker 278. In addition, a plurality of reference numerals 298 can be located near each of the reference markers 197 described above to assist in positioning the second segment portion 220 relative to the first segment portion 214. These reference numbers 298 may indicate the relative position of the reference indicia, or may correspond to a particular size or number of orthopedic implants corresponding to the appropriate implant that the tool 200 will present.

  12-14, the second segment portion 220 can be selectively secured to the first segment portion 214 in any suitable manner. For example, the second segment 220 may have a locking feature to selectively and lockably secure the second segment 220 to the first segment 214. it can. For example, the sliding portion 252 can have a threaded hole 206 passed through the slot 250. In addition, a screw 208 can be fixed in this threaded hole 206 by screw engagement. The screw 208 is considered to be similar to the screw 292 used in the main body portion 210. The screw 208 may also have a constant spring loaded ball tip. Further, the offset slide portion 242 in the first segment portion 214 can have a plurality of recesses 209 that provide a predetermined position in engagement with each of the reference numerals 298 described above.

  Referring again to FIG. 8, the third segment 233 is slidably connected to the second segment 220 and is movable in the direction of arrow 217.

  14, 15, 16 and 17, the third segment 233 is shown in greater detail. This third segment portion 233 has a generally cylindrical shape and has a central hole 218 and two arcuate openings 219 as shown in FIG. The third segment 233 can be slidably secured to the neck 254 of the second segment 220 in any suitable manner. For example, a pin 219 can be matedly secured to the hole 218 in the third segment 233. Further, the pin 219 can be slidably fitted into the opening 221 in the neck portion 254 of the second segment portion 220.

  Alternatively or additionally, for use of the pin 219, the third segment portion 233 may have a central slot 223 into which the neck portion 254 can slidably fit.

  The third segment portion 233 can be selectively and fixedly attached to the second segment portion 220 in any suitable manner. For example, the third segment portion 233 can have a threaded hole 225 to which the screw 227 can be threadably engaged. The screw 227 is considered to be similar to the screw 208 described above and may have a constant spring-loaded spherical tip. To provide a predetermined position, the second member 220 can have a plurality of recesses 228 that can be aligned with the screws 227 to provide a predetermined position. These predetermined positions can be aligned with reference numeral 243.

  14 to 16, a neck portion 254 of the second segment portion 220 has a fixed neck center line 229 extending at a fixed angle ββ with respect to a sliding center line 231 of the sliding portion 252. Along the sliding portion 252 of the second segment portion 220.

  To assist in observing the position of the third segment portion 233 relative to the second segment portion 220, the second segment portion 220 and / or the third segment portion 233 may Pointing means 241 for determining a relative position with respect to the second segment portion 220 can be provided. For example, the indicating means 241 can be in the form of a plurality of markers 245 on the neck portion 254 of the second segment portion 220 and a single marker 248 located on the third segment portion 233. In addition, the indicating means 241 can include a plurality of reference numbers 243, which can be positioned in alignment with each marker 245, and can be used to identify specific markers between each adjacent marker 245. It may correspond to a separation distance or may correspond to a presented implant corresponding to a particular setting determined in the tool 200 described above.

  18 and 19, another embodiment of the present invention is shown as a tool 300. The tool 300 is similar to the tool 200 in FIGS. 7-17, but instead of the third segment portion 233 of the tool 200, the tool 300 has a generally tapered shape and a constant Has a third segment portion 333 corresponding to the tapered shape of the neck of the prosthesis stem portion. It will be appreciated that the tool 300 may further have indicating means 341 similar to the indicating means 195 in the second segment portion 220 of the tool 200.

  Referring now to FIG. 20, a two piece prosthesis 400 is shown in use in conjunction with the tool 100 described above. The prosthesis 400 has a proximal body portion 410 and a distal stem portion 412. It is to be appreciated that the proximal body portion 410 can have a variety of shapes, including various offset lengths OF and neck lengths NL. Similarly, the distal stem portion 412 can have a variety of dimensions, including various stem lengths SL.

  Referring now to FIG. 21, a monolithic prosthesis 450 is shown. Again, it will be appreciated that the prosthesis may have a variety of shapes having various lateral offsets LOF, neck length NLS, and stem length SLH.

  Referring now to FIG. 22, various proximal and distal body portions for use with the prosthesis 400 are shown. These proximal body portions include a constant size 6 proximal body portion 420, a size 8 proximal body portion 422, and a size 10 proximal body portion 424. In addition, these proximal body portions also include a constant size 40 proximal body portion 430, a size 21 proximal body portion 432, and a size 0 proximal body portion 434. A preferred distal stem in the short stem 450, the medium stem 452, and the long stem 454 corresponds to, for example, one of these three possible stems, respectively. By using a sliding arm 199 (shown in phantom) that can extend from the base 110 with pointing means (not shown), the template 100 (see FIG. 1) It will be appreciated that it becomes selectable with the use of た い.

  Next, in FIGS. 1 and 22, each reference numeral 186 in the tool 100 corresponds to each of the proximal body portions 430, 432, and 434. Therefore, as shown in FIG. 1, if the appropriate distance height is a constant size 0, that is, if the reference numeral 186 is aligned with the body part indicator 178, A suitable proximal body portion is the proximal body portion 434 described above.

  Similarly, in FIGS. 1 and 22, if the appropriate offset is a constant size 8, ie, if the reference numeral 198 in the second segment portion 120 matches the first segment indicator 196, This reference number 8 corresponds to the selection of the proximal body portion 422 described above.

  23 and 24, a multi-piece prosthesis hip femoral component 500 is shown. The thigh component 500 has a distal stem 502 connected to a proximal body portion 504. Further, a head 506 is connected to the proximal body portion 504. Also, a sleeve 508 fits over the proximal body portion 504. In addition, a nut 509 is used to secure the proximal body portion to the distal stem 502.

  Referring now to FIGS. 25, 26 and 27, a plurality of distal stem portions, proximal body portions, and head portions, respectively, for use in connection with tool 200 in FIGS. 7-17 above are shown. . For example, in FIGS. 7 and 25, a certain proximal body portion may be set with an appropriate offset by the second segment portion 220 of the tool 200 and observed with an appropriate number 298 with an appropriate offset. You can choose. By referring to this proper number 298, a suitable proximal body portion corresponding to this can be selected. For example, if the displacement is zero (0), the proximal body portion 520 is selected, if the displacement is size 6, the proximal body portion 522 is selected, and if the displacement is size 8, The proximal body portion 524 will be selected if the displacement is size 12, and the proximal body portion 526 will be selected. The preferred distal stem of the short stem 650, the medium stem 652 and the long stem 654 corresponds to, for example, one of these three possible stems, respectively. The template 100 of the present invention (see FIG. 1) by using a sliding arm 199 (shown in phantom) that can extend from the base 110 with a pointing means (not shown) It will be appreciated that it becomes selectable with the use of (see).

  7 and 26, the appropriate proximal body portion can be selected by examining the Kalkar size (distance height) indication by the tool 200 as observed by reference numeral 286 for that body portion. become. For example, in the case of the reference numeral 40, the proximal body portion 630 is selected. When the calcar size (reference numeral) is 21, the proximal body portion 632 is selected, and when the calcar size is 0, the proximal body portion 634 is selected.

  Next, in FIGS. 27 and 14, an appropriate head unit can be selected based on each reference numeral 243 selected by the indicating means 241 as shown in FIG. For example, when the number is 6 at the center of the head, the head 640 is selected, when the center is 12 at the head, the head 642 is selected, and when the center is 0 at the head, the head 644 is selected. In the case of the center 3, the head 646 is selected, and in the case of the center 9, the head 648 is selected.

  Referring now to FIG. 28, a method 700 for selecting one of a plurality of prosthetic components for use in arthroplasty is shown. The method 700 includes a first step 702 of obtaining a radiographic image of a bone anatomy of a patient. The method 700 also includes a tool having a first portion for registering a first portion in the radiographic image and a second portion for registering a second portion in the radiographic image. A second step 704 of providing a first portion of the tool with respect to a second portion of the tool, the tool measuring at least one dimension in the radiographic image. Used for Further, the method 700 includes a third step of aligning a first portion of the tool with a first portion of the radiographic image. The method 700 also includes a fourth step 708 of aligning a second portion of the tool with a second portion of the radiographic image. Further, the method 700 includes a fifth step 710 of using the tool to measure at least one dimension in the radiographic image, and based on the measured dimensions, the plurality of prosthesis components. A sixth step 712 of selecting one is included.

  Referring now to FIG. 29, a method 800 for selecting one of a plurality of prosthetic components for use in arthroplasty is shown. The method 800 includes a first portion for aligning a first portion of a bone anatomy of a patient and a second portion for aligning a second portion of the bone anatomy. A first step 802 of providing a tool having a first portion 802, wherein a first portion of the tool is movable with respect to a second portion of the tool, the tool comprising Used to measure at least one dimension. The method 800 also includes a second step 804 of aligning a first portion of the tool with a first portion in the bone anatomy. Further, the method 800 includes a third step 806 of aligning a second portion of the tool with a second portion in the bone anatomy. The method 800 also includes a fourth step 808 of using the tool to measure at least one dimension in the bone anatomy, and the plurality of prosthesis components based on the measured dimension. A fifth step 810 of selecting one of the two.

  While the invention and its various advantages have been described in detail above, various modifications, substitutions and changes may be made without departing from the spirit and scope of the invention as defined by the appended claims. It is understood that what can be done in is understood.

  The present invention is applicable to certain prosthetic implants with additional functionality and related methods. The device is an adjustable device that allows the user to slide the neck in a lateral direction from a center to template the lateral offset. The device is also slidable in a constant proximal to distal direction up to the length of the template foot. Optionally, the instrument can slide in an oblique direction to template either the length of its neck or the length of the head or a combination thereof. In addition, a certain portion of the device is etched to indicate the actual lateral shift, foot length and neck length, respectively, and to aid in the selection of the implant. It is possible.

Specific embodiments of the present invention are as follows.
(1) a second segment portion, wherein the second segment portion is movable with respect to one of the main body portion and the first segment portion; The tool of claim 1, wherein the portion is a portion for aligning with a third portion of the anatomical joint.
(2) Further, a third segment portion is provided, and the third segment portion is movable with respect to one of the main body portion, the first segment portion, and the second segment portion. The tool of claim 1, wherein the third segment portion is a portion for aligning with a fourth portion of the anatomical joint.
The tool of claim 1, wherein the body portion defines a passage therein, and wherein the first segment portion is guideable within the passage.
(4) At least one of the main body portion and the first segment portion has an indicator at an upper portion thereof for determining a relative position of the main body portion with respect to the first segment portion. The described tool.
5. The tool of claim 1, wherein at least one of the body portion and the first segment portion includes a portion that is translucent.

6. The tool of claim 1, wherein at least one of the body portion and the first segment portion are selectively and fixedly attachable to one another.
(7) The tool according to claim 1, wherein the image is an X-ray image of an anatomical joint.
(8) The main body portion has a fixed main body portion indicating means on an upper portion thereof, and the first segment portion has a plurality of segment portion indicating means on an upper portion thereof, and the segment portion indicating means is provided. The tool of claim 1 wherein at least a portion of the tool corresponds to certain recommended dimensions of the prosthesis implant.
(9) The tool of embodiment (9), wherein the recommended dimensions of the prosthesis implant are one of a taller height, a displacement, and a neck length.
(10) The tool according to claim 2, wherein one of the specified various dimensions is a height of a distant portion.

(11)
A second segment portion, the second segment portion being movable with respect to the first segment portion, wherein the first segment portion is used in measuring a height of a distance. 3. The tool of claim 2, wherein the second segment portion is a portion for use in measuring misalignment.
(12) Further, a third segment portion is provided, the third segment portion is movable with respect to the second segment portion, and the third segment portion measures a length of the neck portion. The tool of embodiment (11), which is a part for use in doing.
(13) At least one of the main body portion and the first segment portion has an indicator means thereon for measuring at least one of the specified various dimensions. Tools described in.
14. The tool of claim 2, wherein at least one of the body portion and the first segment portion includes a translucent portion.
(15) The tool according to claim 2, wherein at least one of the body portion and the first segment portion is selectably fixedly attachable to each other.
(16) The main body portion has a fixed main body portion indicating means on an upper portion thereof, and the first segment portion has a plurality of segment portion indicating means on an upper portion thereof, and the segment portion indicating means is provided. 3. The tool of claim 2, wherein at least a portion of the tools correspond to certain recommended dimensions of the prosthesis implant.

For a more complete understanding of the present invention and the advantages of the present invention, reference is made to the following description taken in conjunction with the accompanying drawings.
FIG. 2 is a plan view of an adjustable template according to a first embodiment of the present invention with a lateral offset and foot length adjustment mechanism. FIG. 2 is a perspective view of a main body of the template in FIG. 1. FIG. 3 is a plan view of a main body in FIG. 2. FIG. 2 is a perspective view of a first segment of the template in FIG. 1. FIG. 2 is a perspective view of a second segment of the template in FIG. 1. FIG. 2 is a plan view of the template of FIG. 1 shown positioned relative to a contour of a femur. FIG. 11 is a plan view of an adjustable template according to another embodiment of the present invention with a mechanism for adjusting lateral offset, foot length, and head center. FIG. 8 is an exploded plan view of the adjustable template of FIG. 7. FIG. 8 is a side view of the adjustable template of FIG. 7. It is a top view of the main-body part in the template of FIG. FIG. 11 is a plan view of the body portion of a mirror image body relative to the body portion of FIG. FIG. 8 is a plan view of a first segment portion in the template of FIG. 7. FIG. 8 is a side view of a second segment portion in the template of FIG. 7. FIG. 14 is a plan view of a second segment part of FIG. 13. FIG. 14 is a rear view of the second segment part of FIG. 13. It is a top view of the head part in the template of FIG. FIG. 17 is an end view of the head section of FIG. 16. FIG. 6 is a partially exploded plan view of another embodiment of an adjustable template according to the present invention. FIG. 19 is a cross-sectional view along the line 19-19 of FIG. 18 in the direction of the arrow. FIG. 3 is a plan view of a modular hip stem for use with the template of the present invention. FIG. 4 is a plan view of a monolithic hip stem for use with the template of the present invention. FIG. 21 is a plan view of the hip joint stem of various dimensions of FIG. 20. FIG. 9 is a plan view of another configuration of a modular hip stem for use with the template of FIG. 1 or the template of FIG. FIG. 24 is an exploded plan view of the modular hip joint stem of FIG. 23. FIG. 24 is a plan view of the proximal body portion of the hip stem portion of FIG. 23 of various dimensions. FIG. 24 is a plan view of variously sized distal stem portions of the hip stem portion of FIG. 23. FIG. 24 is a plan view of various sizes of heads of the hip joint stem of FIG. 23. 5 is a flow chart of a method for performing arthroplasty according to the present invention. 5 is a flow chart of another method for performing arthroplasty according to the present invention.

Explanation of reference numerals

REFERENCE SIGNS LIST 100 tool 101 anatomical joint 102 radiographic plate 104 radiographic image 110 body portion 112 first portion 114 segment portion 116 second portion 120 second segment portion 122 third portion 124 stem portion 130 slot 132 First segment base 134 Calker slide 140 Rail 142 Offset slide 146 Rail 150 Slot 152 Sliding portion 154 Neck portion 160 Proximal lip 162 Distal lip 164 Groove 176 Pointing means 400 Graft

Claims (4)

A tool for assisting in selecting an appropriately sized implant for use in performing arthroplasty, the tool comprising an anatomical joint and an anatomical joint A tool for cooperating with at least one of the images of the above, further comprising a body portion for alignment with a first portion of the anatomical joint, and a segment portion. The segment portion is movable with respect to the body portion, the segment portion is a portion for alignment with a second portion in the anatomical joint, and the body portion and the segment portion are aligned with each other. Measuring the relative position of the first and second portions in the anatomical joint for use in selecting a suitably sized implant A tool that conforms to. Use in measuring at least one of a variety of specific dimensions to assist in selecting an appropriate one of a plurality of femoral components in a hip implant for use in performing hip arthroplasty A tool for cooperating with at least one of an anatomical joint and a radiographic image of the anatomical joint; A body portion for alignment with a first portion of the natural joint, and a segment portion, wherein the segment portion is movable relative to the body portion and the segment portion is The body portion is aligned with the first portion and the segment portion is aligned with the second portion of the joint. When you are in alignment with the portion of the tool used for the tool to measure one of the particular variety of sizes. A method for selecting one of a plurality of prosthetic components for use in arthroplasty, comprising:
Obtaining an x-ray image of the bone anatomy of the patient;
Providing a tool having a first portion for aligning a first portion in the radiographic image and a second portion for aligning a second portion in the radiographic image. A first portion of the tool is movable with respect to a second portion of the tool, wherein the tool is a tool used to measure at least one dimension in the radiographic image;
Aligning a first portion of the tool with a first portion of the radiographic image;
Aligning a second portion of the tool with a second portion of the radiographic image;
Using the tool to measure at least one dimension in the radiographic image; and selecting one of the plurality of prosthesis components based on the measured dimension. A method for selecting one of a plurality of prosthetic components for use in arthroplasty, comprising:
A first portion for matching a first portion of a bone anatomy of the patient and a second portion for matching a second portion of the bone anatomy; Providing a tool, wherein a first portion of the tool is movable relative to a second portion of the tool, the tool measuring at least one dimension in the anatomy of the bone. Aligning a first portion of the tool with a first portion in the anatomy of the bone;
Aligning a second portion of the tool with a second portion of the bone anatomy;
Using the tool to measure at least one dimension in the bone anatomy; and selecting one of the plurality of prosthesis components based on the measured dimension.

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